Tuesday, April 24, 2012

Is there a doctor in the house?

Trying to prepare for every possible situation is not possible or likely, but you can always try your best to prepare for situations you know will happen or are more likely to happen. With turbulent times around the corner being prepared means survival.  While surfing the internet looking for the latest in preppers how tos and just seeing what and how most people prepare it dawned on me no one prepared for a world where there are no doctors and you will have to fix a broken bone by yourself.  We all now have our family doctor that takes care of us and that we go to. However, when shit hits the fan and our society breaks down as we know it and survival is our number one priority and goal to whom will we turn to if we get sick or break a bone? The answer is it will have to be ourselves and our family/neighbors. So unless you are a doctor or you know a doctor that when shit hits the fan you can team up to survive then you will need to do a lot of research and training on how to take care of yourself or a family member is someone is sick or in dire need of medical assistance.  By no means am I  a doctor, all I want to do is inform you on how to best treat yourself and someone that is injured. Practicing with a doctor who is willing to train on how to do something such as fixing a broken bone, or treat an injury is preferred. This is for educational purposes only, please do not try this while we have doctors save it for when shit hits the fan. I am not responsible for what you do with this information or knowledge.

Book and other readings
 For anyone who has been reading this blog, knows I love amazon and my books. Books are especially important for this subject. Also please read all you can on this subject and train as well. Also go to classes for EMTs. The more one knows about this subject the better prepared you will be. This skill is as essential as shooting a gun or knowing how to gut an animal.  So now on to some great books. 

Since 1986, Medicine for the Outdoors has been hailed as the definitive take-along manual on the subject. Packed with step-by-step instructions, how-to explanations, and practical approaches to outdoor and wilderness emergencies, it tells you the best ways to respond to just about any medical problem when help is miles or days away. Author Paul S. Auerbach, MD, MS, FACEP, FAWM, is recognized as one of the world's leading authorities on wilderness medicine. This 5th edition features major updates to bring you the latest on emerging infectious diseases...the most current drug and dosage information...an increased emphasis on making do with the materials at hand...and much more. Logically organized, easy to reference, and simple to understand, Medicine for the Outdoors may literally save your life. When you're venturing into mountains, deserts, forests, jungles, or out to sea, it belongs in your duffel or backpack!
  • Provides the most diverse and comprehensive coverage of medical conditions related to the outdoors.
  • Offers logical and complete explanations of every topic.
  • Includes numerous drawings and instructions to enhance your understanding of the descriptive material.
  • Contains recommendations for injury and illness prevention.
  • Features a comprehensive index that helps you locate answers quickly.
  • Offers an increased emphasis on making do with the materials at hand (like using a fanny pack as a cervical collar).
  • Presents the latest guidance on dangerous infections like methicillin-resistant Staphylococcus aureus (MRSA), avian flu, and West Nile virus. 
  • Offers current and accurate drug and dosage information via careful updates throughout. 
  • Provides new safety recommendations on avalanches, forest fires, bear attacks, and more. 
  • Demonstrates how to apply various bandages and splints with the aid of brand-new drawings.

Delivering the facts to your fingertips, the Oxford Handbook of Tropical Medicine provides an accessible and comprehensive, signs-and-symptoms-based source of information on medical problems commonly seen in the tropics. A handy guide which can fit in the coat pocket and be used easily at the bedside, it has been designed to be as practical as possible with illustrations of blood films and stool smears, which are useful for diagnosis, as well as clinical features, diagnosis, and management. Medical conditions are ordered by system except for the five major tropical conditions - malaria, HIV/STIs, tuberculosis, diarrhoeal diseases, and acute respiratory infections - and fevers. In this new edition the sections on malaria, cardiology, chest medicine, gastroenterology, mental health and dermatology have undergone major revision, and there is new material on altitude sickness, heat stroke, avian flu and fuller poisoning. There is a greater emphasis on pediatric medicine and public health throughout, and new illustrations and photographs have been included to aid with diagnosis. Small enough to throw in your rucksack, this unique handbook is the ultimate quick reference guide for all those working in the tropics. THIS BOOK IS A MUST HAVE!!! IF YOU DO NOT HAVE IT BUY IT NOW!!!!!!!!!!!!!!

Hesperian's classic manual, Where There Is No Doctor, is perhaps the most widely-used health care manual in the world. 

Useful for health workers, clinicians, and others involved in primary health care delivery and health promotion programs, with millions of copies in print in more than 75 languages, the manual provides practical, easily understood information on how to diagnose, treat, and prevent common diseases. Special attention is focused on mutrition, infection and disease prevention, and diagnostic techniques as primary ways to prevent and treat health problems. 

This 2010 reprint features updated medicines, plus information on tuberculosis and HIV, including guidelines for anti-retroviral therapy and preventing HIV in babies.

Completely revised and updated, the new edition of this portable guide offers fast-access solutions to all of the medical situations that can occur in non-traditional settings. Based on Dr. Auerbach's critically acclaimed text Wilderness Medicine, 5th Edition, this handbook is packed with how-to step-by-step explanations and the latest practical advice on diagnosis and treatment-emphasizing ways of improvising care with whatever materials you have available. It's small enough to be carried in a car's glove compartment or in your backpack-yet detailed enough to cover the clinical presentation and treatment of a full range of emergencies!
  • Offers appendices that address everything from environment-specific situations to lists of essential supplies, medicines, and many additional topics of care, enabling you to meet a full-range of emergency situations with the utmost effectiveness.
  • Includes line drawings-along with a section of color plates-that aid in the identification of skin rashes, plants, snakes, insects, and more.
  • Provides Signs and Symptoms and Treatment sections in most chapters-combined with bulleted lists and text boxes-that facilitate quick and easy retrieval of information.
  • Presents full chapter coverage of both animal attacks and zoonoses for handling life-threatening situations.
  • Features peerless guidance in a portable format for consultation anywhere from the office setting to the open outdoors.
  • Features a new appendix on jungle travel and survival, and new chapters on forest fires, bandaging and taping techniques, mental health, hydration and dehydration, malaria-and more-equipping you to handle any emergency you might encounter in the wilderness.
  • Includes more tips for improvisational care (eg, how to make a rigid litter using skis, poles, snowshoes, canoe paddles, or tree branches) to help you respond to wilderness and nontraditional emergencies with the materials that you have on hand.
  • Presents thorough revisions to all previously existing chapters-ensuring that you have the latest knowledge at your fingertips.

The fifth title in Process’ Self-Reliance series demystifies medical practices with a practical approach to twenty-first-century health and home medicine, particularly helpful in a financial downturn.
When There Is No Doctor is smartly designed and full of medical tips and emergency suggestions. At a time when our health system has become particularly susceptible to strain, it should be no further than an arm’s reach away in your household.
This is a book about sustainable health, primarily having to do with your health and what you can do to protect it—in bad times certainly, but also in good. I will help you ensure the health of those you love, yourself and, should you so choose, your community, if and when the world changes. World may come to mean your little town or the whole globe. It could change for a few days or weeks, or for a few years. It could change because of a flood, financial crisis, flu pandemic, or failure of our energy procurement, production or distribution systems.
I will not teach you to be a lone survivalist who anticipates doing an appendectomy on himself or a loved one on the kitchen table with a steak knife and a few spoons, although I will discuss techniques of austere and improvised medicine for really hard times.

Broken Bones Sprains and much more

Probably one of the worst things to happen to someone who is trying to survive is for them to break an arm or a leg.  With either one broken or badly injured your chances of survival are slim and it just makes everything you do a lot harder.  

  1. Apply a Cast to a Broken Arm
  2. Attempt to recruit at least one helper to assist with the holding and positioning of the arm, as well the preparation and application of the plaster.
  3. Position the patient comfortably with his/her injured arm gently resting on a waist-high table. To help ease the patient's discomfort, explain each step of the casting procedure as you work.

  4. Pad the arm with a soft, resilient material
    . Orthopedic padding, wool or felt are examples of ideal padding material.
    • Unroll the padding firmly over the area, overlapping each turn approximately one-third of the padding's width to ensure secure layers.
    • Place additional padding over prominent bones, such as the wrist or elbow.

  5. Properly align the affected bone and have an assistant hold and maintain the position for the duration of the casting procedure

  6. Immerse plaster rolls one at a time as needed, in warm water until all air escapes and the bubbling stops
    . Soak a new roll of plaster when about half of the current roll has been applied so it will be ready when needed.

  7. Remove and gently squeeze out excess water

  8. Unroll the plaster around the arm
    . Begin about .5 inches in from the edge of the existing padding and use only circular turns while applying minimum tension.

  9. Smooth the plaster with the palms of your wet hands, while applying, in order to properly mold the bandages to the contour of the arm

  10. Apply a second layer of plaster over the first using the same rolling and smoothing procedure
    . The excess .5 inches of padding should be folded over and incorporated into the second layer.

  11. Apply the third, and final, layer of plaster
    . When finished, smooth the exterior layer well using wet hands.

  12. Use scissors to trim any excess plaster from around the thumb and/or fingers to ensure proper range of motion

  13. Allow the cast to dry for 30-to-60 minutes


There are basically two types of fractures: open and closed. With an open (or compound) fracture, the bone protrudes through the skin and complicates the actual fracture with an open wound. After setting the fracture, treat the wound as any other open wound.
The closed fracture has no open wounds. Follow the guidelines  for immobilization, and set and splint the fracture.
The signs and symptoms of a fracture are pain, tenderness, discoloration, swelling deformity, loss of function, and grating (a sound or feeling that occurs when broken bone ends rub together).
The dangers with a fracture are the severing or the compression of a nerve or blood vessel at the site of fracture. For this reason minimum manipulation should be done, and only very cautiously. If you notice the area below the break becoming numb, swollen, cool to the touch, or turning pale, and the victim shows signs of shock, a major vessel may have been severed. You must control this internal bleeding. Rest the victim for shock, and replace lost fluids.
Often you must maintain traction during the splinting and healing process. You can effectively pull smaller bones such as the arm or lower leg by hand. You can create traction by wedging a hand or foot in the V-notch of a tree and pushing against the tree with the other extremity. You can then splint the break.
Very strong muscles hold a broken thighbone (femur) in place making it difficult to maintain traction during healing. You can make an improvised traction splint using natural material (Figure 4-6) as follows:

  • Get two forked branches or saplings at least 5 centimeters in diameter. Measure one from the patient's armpit to 20 to 30 centimeters past his unbroken leg. Measure the other from the groin to 20 to 30 centimeters past the unbroken leg. Ensure that both extend an equal distance beyond the end of the leg.

  • Pad the two splints. Notch the ends without forks and lash a 20- to 30-centimeter cross member made from a 5-centimeter diameter branch between them.

  • Using available material (vines, cloth, rawhide), tie the splint around the upper portion of the body and down the length of the broken leg. Follow the splinting guidelines.

  • With available material, fashion a wrap that will extend around the ankle, with the two free ends tied to the cross member.

  • Place a 10- by 2.5-centimeter stick in the middle of the free ends of the ankle wrap between the cross member and the foot. Using the stick, twist the material to make the traction easier.

  • Continue twisting until the broken leg is as long or slightly longer than the unbroken leg.

  • Lash the stick to maintain traction.

Note: Over time you may lose traction because the material weakened. Check the traction periodically. If you must change or repair the splint, maintain the traction manually for a short time.


Dislocations are the separations of bone joints causing the bones to go out of proper alignment. These misalignments can be extremely painful and can cause an impairment of nerve or circulatory function below the area affected. You must place these joints back into alignment as quickly as possible.
Signs and symptoms of dislocations are joint pain, tenderness, swelling, discoloration, limited range of motion, and deformity of the joint. You treat dislocations by reduction, immobilization, and rehabilitation.
Reduction or "setting" is placing the bones back into their proper alignment. You can use several methods, but manual traction or the use of weights to pull the bones are the safest and easiest. Once performed, reduction decreases the victim's pain and allows for normal function and circulation. Without an X ray, you can judge proper alignment by the look and feel of the joint and by comparing it to the joint on the opposite side.
Immobilization is nothing more than splinting the dislocation after reduction. You can use any field-expedient material for a splint or you can splint an extremity to the body. The basic guidelines for splinting are--

  • Splint above and below the fracture site.

  • Pad splints to reduce discomfort.

  • Check circulation below the fracture after making each tie on the splint.
To rehabilitate the dislocation, remove the splints after 7 to 14 days. Gradually use the injured joint until fully healed.

If an accident occurs in the wilderness it will be your responsibility to deal with the situation. The specific sequence of actions when dealing with this situation is:
1. Remain calm, providing your patient with quiet, efficient first aid treatment.
2. Keep the patient warm and lying down. Do not move this injured person until you have discovered the extent of the injuries.
3. Start mouth-to-mouth artificial respiration immediately if injured person is not breathing
4. stop any bleeding
5. Give your patient reassurance. Watch carefully for signs of shock.
6. Check for cuts, fractures, breaks and injuries to the head, neck or spine.
7. Do not allow people to crowd the injured person.
8. Do not remove clothing unless it is imperative.
9. Decide if your patient can be moved to a proper medical facility. If this is not possible, prepare a suitable living area in which shelter, heat and food are provided.

Shock is a depression of all of the body processes and may follow any injury regardless of how minor. Factors such as hemorrhage, cold and pain will intensify shock. When experiencing shock the patient will feel weak and may faint. The skin becomes cold and clammy and the pulse, weak and rapid. Shock can be more serious than the injury itself.
Use the following method to prevent and control shock:
1. When treating injuries:
i. restore breathing
ii. stop bleeding
iii. treat breaks and fractures
2. If there are no head or chest injuries place the patient on his/her back with the head and chest lower than the legs. This will help the blood circulate to the brain, heart, lungs and other major organs.
3. If severe head and chest injuries are present elevate the upper body. If chest injuries are present, elevate the injured side to assist in the functioning of the uninjured lung.
4. If the injured person becomes unconscious, place him/her in a face down position to prevent choking on blood, vomit or the tongue.
5. Keep your patient warm and under shelter.

If breathing has stopped, begin mouth-to-mouth resuscitation. Place the patient on his/her back and follow these steps:
1. To open the airway lift the patient's neck and tilt the head back.
2. Keeping the neck elevated, pinch the nostrils to prevent air leakage.
3. Place your mouth completely around the victim's mouth and blow, watching for chest expansion.
4. After removing your mouth, listen for air leaving the patient's lungs and watch for the chest to fall. Check for an airway blockage if the chest does not rise.
Repeat these steps approximately 12 to 15 times per minute. If treating a child, cover the nose and mouth with you mouth. Use smaller puffs of air and repeat this method 20 to 25 times per minute.

To control bleeding, elevate the wounded area above the heart and apply pressure using either gauze, clean cloth, dried seaweed or sphagnum moss. Use pressure at the pulse point between the injured area and the heart if bleeding fails to stop. If bleeding still persists, use a tourniquet between the injury and the heart. This method should only be used in extreme situations. After bleeding has been controlled, wash the wounded area with disinfectant and apply a dressing and bandages.

A fracture is classified as either a simple (closed) or compound (open). Signs that a fracture is present include:
1. Pain at the affected area.
2. The area may or may not be deformed.
3. The victim is unable to place weight on the area without experiencing pain.
4. A grating sensation or sound may be present during any motion of the injured area.
Treatment is as follows:
1. If in doubt, treat the injury as a fracture. 2. Splint the joints above and below the fracture.
3. If the fracture may penetrate the skin, it could be necessary to apply traction to straighten the deformity.
4. Be sure to pad your splints. 
. Check the splint ties frequently to be sure they do not hinder circulation.
6. Cover all open wound with a clean dressing before splinting.

Dislocation happens when the ligaments near a joint tear, allowing the movement of the bone from its socket. It is unwise to treat a dislocation unless you are a trained professional as permanent damage may occur. The affected extremity should be supported using a sling or other device and pain controlled with aspirin or other suitable drugs.

Treat sprains by applying cold to the area for the first 24 hours then once the swelling has subsided, let the sprain sit for a day. Apply heat the following day to aid in the healing process. The sprain should be splinted and rendered immobile until the pain has completely disappeared.

Concussions or other head injuries are often accompanied by a leakage of watery blood from the nose or ears. Other symptoms may include convulsions, an unresponsiveness of the pupils or headache and vomiting. Keep the injured party warm, dispense a pain killer regularly and allow time for the body to rest and repair.

Heat exhaustion is not uncommon when water is not sufficient. The body becomes dehydrated and salt-depleted, resulting in nausea, faintness, a weak, rapid pulse and/or cold and clammy skin. Treatment includes plenty of rest, liquid and salt tablets.

Sunstroke may occur when the body is exposed to excessive sun. The body becomes overheated and provides too much blood to the circulatory system resulting in a flushed, hot face, rapid pulse, headache and/or dizziness. Treat sunstroke by resting in a cool area and applying and consuming cold liquid. Prevent sunstroke by wearing proper headgear.

Muscle cramps occur when the muscle accumulates excessive lactid acid or a loss of salt through perspiration. Treatment includes resting, deep breathing and stretching. Restore the salt balance immediately.

Burns are most commonly followed by shock. Administer a pain reliever immediately, apply gauze covered in Vaseline to the affected area and bandage. The patient should consume more water than usual.

Symptoms of snowblindnessinclude scratchy or burning eyes, excessive tearing, sensitivity to light, headache, halos around light and temporary loss of vision. Bandage the victim's eyes and use cold compresses and a painkiller to control the pain. Vision will generally be restored after 18 hours without the help of a doctor. Always wear snow goggles or sunglasses in snowy areas to prevent snowblindness.

Frostbite occurs when the tissue of an area, most commonly the toes, fingers or face, is frozen either from direct exposure to the elements or high wind. First degree frostbite turns the area cold, white and numb. When heated the area becomes red and can be compared to a first degree burn. A blister will form after warming with second degree frostbite. Dark skin, gangrene, and a loss of some skin and tissues is common in third degree. Fourth degree frostbite causes irreparable damage. The affected area will remain cold and lifeless and generally a part of the area is lost. With adequate clothing frostbite can easily be avoided. Superficial frostbite may be treated by cupping one's hands and blowing on the affected area, warming from another warm hand or, with fingers, placing them in your armpits. For more severe cases, medical aid should be sought.

Blisters are the painful, and common, result of ill-fitting footwear. At the first sign of discomfort, remove boots and socks and place a piece of adhesive tape over the affected area. If it is absolutely necessary, open a blister by first washing the area thoroughly then inserting a sterilized needle into the side of the blister. Apply disinfectant and a bandage.

Headaches are often experienced in the mountains due to inadequate eye protection, tension in the neck, constipation or "water intoxication", a swelling of the brain tissue which happens when the hiker has sweated excessively over a period of days and consumed large quantities of water without taking salt tablets. Aspirin may be used to alleviate the pain but one should find the source of headache to prevent further discomfort.

Snake bites are not overly common in British Columbia. One species of venomous snake, a rattlesnake is found in the dry belt of the southern interior. If you come across a snake slowly ease back. A snake bite rarely causes death; victims may be left untreated for up to eight hours.
After an attack occurs:
1. Keep the person calm, reassuring them that bites can be effectively treated in an emergency room. Restrict movement, and keep the affected area just below heart level to reduce the flow of venom.
2. Remove any rings or constricting items because the affected area may swell. Create a loose splint to help restrict movement of the area.
3. If the area of the bite begins to swell and change color, the snake was probably poisonous.
4. Monitor the person’s vital signs -- temperature, pulse, rate of breathing, blood pressure. If there are signs of shock (such as paleness), lay the victim flat, raise the feet about a foot, and cover the victim with a blanket.
5. Get medical help immediately.

Bee stings are common and harmless unless you are allergic. Remove the stinger then apply disinfectant and clod water to reduce the swelling.
A change of diet, dirty cooking utensils or the consumption of tainted water may result in diarrhea which in turn will cause a loss of nutrients and precious body fluids. Take extra care in cleanliness and boil water for an additional three to five minutes to avoid diarrhea.

When the temperature of your body falls to a level at which your vital organs can no longer function you are experiencing hypothermia or exposure sickness. Hypothermia will develop rapidly and is caused by cold, wet and/or windy weather that chills the body at a speed faster than it can produce heat. A lack of energy-producing food and proper clothing will heighten the speed at which hypothermia will affect you. Always remember to bring extra clothing. It is important to hike at the speed of the slowest member of your party. Take frequent breaks and keep a close watch for members experiencing signs of fatigue. Exposure sickness generally occurs in temperatures of less than 10 C (50 F).
Symptoms are easily recognizable:
1. Feeling cold and constantly exercising to keep warm.
2. Uncontrollable shivering and numbness.
3. Violent shivers. Your mind becomes slow and starts to wander.
4. Violent shivering ceases and muscles begin to stiffen and become un-coordinated. Exposed skin becomes blue and thoughts are foggy. Victim usually lacks the capability of realizing how serious the situation is.
5. Pulse and respiration slows.
6. Victim will not respond and becomes unconscious.
7. The section of the brain controlling the heart and lungs ceases functioning.
Treatment must be quick and efficient:
1. Move the victim to a sheltered area, out of the elements.
2. Remove wet clothing and replace with dry clothes and if possible, a sleeping bag.
3. Wrap warm rocks and place them near the patient.
4. Do not let the victim fall unconscious.
5. Give the victim a warm, non-alcoholic drink.
6. Allow another person in the sleeping bag to share body heat.
7. Exhale warm air near the vicinity of the patients mouth and nose.

Hyperthermia is a result of the body being overheated due to increased air temperature, solar or reflected radiation, poorly ventilated clothing, a low fitness level or excess bulk.
Symptoms include:
1. Heat cramps may occur and should be treated by moving the victim to a shady area and supplying water and salt tablets.
2. Heat exhaustion is a mild form of hyperthermia and includes symptoms such as headache, dizziness, fainting, clammy skin, blurred vision, nausea and vomiting. Treatment is the same as heat cramps.
3. Heat stroke is the most serious degree of hyperthermia. The victim will have little or no perspiration, a hot and flushed face, full pulse, and become either apathetic or aggressive. Cool the victim as quickly as possible paying extra attention to the head, neck and chest. If the bodies temperature continues to rise, unconsciousness, delirium, convulsions and ultimately death may occur.
To avoid hypothermia, avoid strenuous activity on hot days, wear loose clothing and a hat, drink plenty of fluids and take salt tablets.

sources: http://www.wilderness-survival.net/medicine-4.php

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